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Examining the Role of Mental Health Interventions in Enhancing
Student Retention Rates in State Universities
Cris Marie Gil D. Hamo-ay., Ronie G. Panes
College of Development Management, University of Southeastern Philippines, Davao City, Davao del
Sur, Philippines
DOI: https://dx.doi.org/10.47772/IJRISS.2025.910000632
Received: 08 November 2025; Accepted: 14 November 2025; Published: 20 November 2025
ABSTRACT
This paper explores the role of mental health interventions in enhancing students’ retention in state universities
and colleges (SUCs), highlighting the importance of early interventions in addressing the issue at hand. The
researcher employs the PSALSAR and PRISMA framework to arrive at a systematic literature review for data
brevity and depth. Additionally, the researcher also reviews the various and relevant reports, literature, and
published works from different sources thereby widening the scope to draw more relevant results.
Keywords: mental health, State Universities and Colleges, Davao City, interventions, retention, stress
INTRODUCTION
It has been well-established both in the local, national, and international spheres and systems of laws that
education is considered a right and not just a privilege (United Nations, n.d.). Every individual is entitled to
universal access to education regardless of one’s age, sex, gender, race, ethnicity, and religion. In line with
these, the states are deemed as the enabling actors that carry the utmost responsibility and duty to guarantee
that the common citizens are afforded the opportunity to improve their lives. The government, both on the
local and national levels, has the obligation to ensure that citizens have equitable access to education.
The Philippine government bears the same responsibility and duty to its constituents, the Filipino people.
Currently, the government has enacted Republic Act (R.A.) No. 10931, otherwise known as the “Universal
Access to Quality Tertiary Education Act”, a law that aims to provide free tuition for tertiary education in
SUCs. As part of its requirements, the law provides that students should be enrolled in any state university to
avail of the free tuition. The requirements are enumerated in section 4 (Official Gazette, 2017). Consequently,
this means that students should pass the entrance examination, admission, and retention requirements of the
SUCs they choose to enroll in.
Based on (CPBRD, 2024), there are 12.5% (twelve and 5/100 percent) SUCs recognized by the Commission
on Higher Education (CHED. This is equivalent to 112 SUCs. Three of these SUCs are located in Davao City.
Since the enactment of the said law, there has been an increasing trend in the enrollment in SUCs. In S.Y.
2022-2023 alone, enrollment in the baccalaureate degrees in SUCs went up to 1,710,102 from 1,641,607
enrolled students in S.Y. 2016 (CHED, 2016). However, the likelihood of students discontinuing their
education due to various challenges continues to prevail. In connection, SUCs have imposed more rigorous
guidelines for students’ grades and academic performance. This has become one of the reasons why students
are experiencing mental health issues, especially those students who are particular about their grades.
Conversely, SUC graduates in the Philippines are said to have higher intellectual standards and can meet the
ever-changing demands of society (Tayco et al., 2022). For instance, students who want to study at the
University of the Philippines (UP) need to pass an exacting entrance examination (Lomer & Lim, 2022). Some
even enroll in review centers to prepare for it. Considering this, most graduates from the said institution will
have a higher possibility of landing better jobs with higher pay. Additionally, (Cubero, et. al., 2024) points out
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that this is also attributable to the admission examination and intellectual trainings (e.g., critical thinking and
problem-solving skills) students gain during their stay in their respective institutions (Cubero, et. al., 2024).
However, albeit the aforementioned positive outcomes and impact, students’ mental health issues increasingly
prevail. Undeniably, the current condition of society and educational system have contributed to this.
Throughout the years, Filipinos have developed a mindset of putting academic stress on students which
imposes crushing pressure at times to always perform well no matter what. Basically, stress is an individual’s
response to a situation indicated by irritation, hyper arousal, and low tolerance for frustration (Pavel, et. al.,
2021). This leads to mental health breakdowns among students. According to (Deng, et. al., 2022), family and
environment can cause academic stress to students, affecting their academic performances in the long run.
(Cordova, et. al., 2023) concurs that academic stress is a valid predictor of mental health breakdowns of
university students. Also, the latter researcher highlights that the sudden shift in the environment, assignments,
and other tasks contributes to the students’ academic stress especially for those students who are in their first
year as they are still in the adjustment period, transitioning from being high school students to college students.
Given all these, it is clear that implementing effective and student-centric interventions are important to
properly address the mental health issues SUC students face. It is crucial for the early detection of mental
health issues among students. In (Richter, et. al., 2022) study, mental health issues manifest as early as the age
of 14 to 25 years old. Students from Philippine universities falls under the said ranges. In fact, in the
Philippines, (Hamaideh, et. al., 2022) posits that university students frequently deal with academic, social,
psychological, and physical obligations that raise their risk and sensitivity to psychological suffering including
stress, anxiety, and depression. (Argao, et. al., 2021) reveals that psychological anguish is more common and
severe among university students than among adults or the general population, and that it impacts students
globally.
Therefore, this study examines mental health interventions by understanding the mental health issues
encountered by university students, especially those who are enrolled in SUCs in the Philippines.
Objectives
This study aims to synthesize the literature related to mental health interventions in SUCs in Davao City. The
Systematic Literature Review (SLR) will contribute to strengthening the mechanism of mental health
interventions in SUCs in Davao City. Through the SLR, the following research questions have been
formulated:
RQ 1: What are the related studies or literature about the mental health stressors of students?
RQ2: What are the factors of mental health breakdowns of students in the Philippines?
RQ3: What are the gaps in the literature about mental health experiences of students in State Universities and
Colleges (SUCs) in the Philippines?
Theoretical Framework of the Study
This study is grounded on the theories focusing on mental health interventions in SUCs in the Philippines. The
theories are as follow:
Lazarus’s Theory of the Transactional Model of Stress and Coping
The Transactional Model of Stress and Coping Theory provides that stress is transactional due to the
interplaying roles of people and environment (Lazaru & Folkman, 1987). The said relationship is mediated by
primary appraisal (e.g., the harm or loss, challenges) and secondary appraisal (e.g., evaluating coping
mechanisms). These appraisals create emotions that guide problem-focused or emotion-focused coping
strategies, continuously modified through reappraisal in a longitudinal, intraindividual process shaped by
personal goals, beliefs, and situational fit.
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In relation to students’ risk to drop out from SUCs, this theory explains that the risk is not just caused by
academic load or financial incapability but also by the transaction between the students and the university
environment, mediated by cognitive appraisal and coping. Students who appraise academic or financial
demands as overwhelming threats with insufficient coping resources are more likely to disengage. Mental
health interventions (e.g., counseling, stress management workshops) can reframe threats as challenges,
enhance secondary appraisal via resource access, and promote adaptive coping which, in turn, can significantly
reduce dropout intent.
Tinto's Student Integration Model
The Student Integration Model (Tinto, 1993) proposes that student persistence is dependent on the degree or
level of academic and social integration into the university. Insufficient integration leads to withdrawal.
External commitments (e.g., financial pressures, family responsibilities) weaken integration and increase
dropout risk, especially among non-traditional students. Poor mental health undermines social integration (e.g.,
isolation, low peer support) and academic integration (e.g., poor performance due to anxiety). Interventions
that improve emotional well-being can strengthen integration and, consequently, retention.
Bean and Metzner’s Student Attrition Model
The Bean and Metzner’s Student Attrition Model extends Tinto’s framework to non-traditional students. Non-
traditional students refer to students who are older, have part-time jobs, or commuter students; all of which are
common in SUCs. The said model highlights external environmental variables (e.g., finances, family,
employment) and psychological outcomes (e.g., stress, satisfaction, goal commitment) as stronger predictors of
attrition than academic integration.
METHODS
This study adopts the Systematic Literature Review (SLR) methodology wherein relevant data, findings, and
insights from extant scholarly investigations are rigorously identified, critically appraised, synthesized, and
presented to systematically address the research questions (Hamo-ay & Salapa, 2025). Additionally, the
researcher gathered data that are relevant to the subject matter being looked into. Afterwards, the data are being
analyzed and synthesized based on their commonality in themes, gaps, and findings. The researcher employs
PSALSAR framework to identify the scope of the study, searching and selecting studies’ mechanisms, and
synthesizing databases to come up with a robust result (Mengist, et. al., 2020).
Subsequently, using PRISMA 2020 (Preferred Reporting Items for Systematic Reviews and Meta-Analyses),
the researcher has been able to concisely lay out the literature related to the focus of the study. Notably, the
PRISMA 2020 follows the chronological steps in SLR, namely: (a) eligibility criteria, (b) information sources,
(c) risk of bias, and (d) synthesis of results (Page, et. al., 2021). This framework guarantees that there would be
continued consistency in the quality standards in writing SLR.
Table 1. PSALSAR Framework in Selection of Studies (Mengist, et. al, 2020)
PSALSAR Framework
Steps
Outcomes
Methods
Protocol
Define the Scope of the study
Only the mental health interventions and other related topics
about mental health and students’ retention
Search
Define the searching strategy
Searching strings such as: mental health, counsel, therapy, peer
support, cognitive behavioral therapy, stress management,
students’ retention, attrition, discontinue or drop out, state
universities, public university, Philippines
Search studies
Google Scholar
Appraisal
Selection of studies
Defining the inclusion-exclusion criteria
Quality assessment of the
studies
Quality criteria
Synthesis
Extraction of data
Extraction template
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Categorize the data
Categorizing the data based on the definitions for further
analysis
Analysis
Data analysis
Qualitative or Quantitative data analysis
Results and Discussion
Presents the gaps, trends, and studies relevant to the topic
Conclusion
Provides conclusion and recommendations
Report
Report writing
Utilization of PRISMA 2020 Framework, follows APA format
Journal article production
Publishing the report to the public
Protocol
Protocol is the first step in the PSALSAR framework. Under this step, the scope of the research and the
relevant domain that best fit the study’s focus has been, or is being, described and identified. During this stage,
the role of mental health interventions in addressing mental health issues in Philippine SUCs is probed and
inspected to explore their causal relationship with each other. The researcher only examines the existing
literature linked to mental health and students’ retention to ensure that the findings drawn would be related to
and connected with the study’s core.
Provided below shows the step-by-step process of utilizing the PRISMA 2020 framework to filter the existing
literatures, particularly those pertaining to grey and duplicate literatures. The researcher made use of this to
secure that only pertinent literatures are included. This subsequently assures the integrity of the findings or
results and the recommendations given by the researcher.
Figure 1. PRISMA 2020 Framework in searching articles, journals, books published for Systematic Literature
Review (Page, et. al, 2021)
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Search
The second step involves the Search step. Under this step, relevant literatures are identified by
comprehensively and strategically using different sources including Google Scholar. In this step, the researcher
selects researches, articles, journals, and books published from the year 2021 up to year 2025. Also, the
researcher ensures that the data are peer-reviewed journal articles and are up-to-date. In relation to the five-
year window, this period is rendered enough to capture the surge in mental health intervention researches that
align with updated institutional policies in state universities.
The researcher input the following significant and applicable keywords in the search engine: mental health,
counsel, therapy, peer support, cognitive behavioral therapy, stress management, students’ retention, attrition,
discontinue or drop out, state universities, public university, Philippines. The primary search yielded a result of
17,400 studies in Google Scholar.
Appraisal
In the Appraisal stage, the SLR answers the objectives of this paper through the disclosure of the inclusion-
exclusion criteria. To effectively and efficiently filter the data, the following inclusion criteria are considered:
a. the title, abstract, and the keywords are seen as a whole or at least the part of the literature of the said
research;
b. the literature relevant to the topic are patently cited books and peer reviewed article journal with keywords:
mental health, counsel, therapy, peer support, cognitive behavioral therapy, stress management, students’
retention, attrition, discontinue or drop out, state universities, public university, Philippines;
c. the paper is written in English;
d. the paper addresses at least one of the three research questions in SLR;
e. the paper’s research location is in the Philippines
f. the duplicated papers are excluded;
g. if the literature is inaccessible, it must be excluded;
h. the papers are published between 2021 up to 2025.
After further consideration and meticulously scanning the relevant literature, taking into account the inclusion
criteria, only 76 studies are deemed as eligible literature.
Table 2. The literature inclusion criteria of the Systematic Literature Review of Mental Health Interventions in
Enhancing Student Retention Rates in State Universities
Decision
Inclusion
Inclusion
Inclusion
Inclusion
Inclusion
Inclusion
To add, Table 3 below presents the list of Final Literature included in the Systematic Literature Review of
Mental Health Interventions in Enhancing Student Retention Rates in State Universities. Upon further
facilitating the inclusion criteria, there are 28 articles remaining in the list.
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Table 3. List of Final Literature included in the Systematic Literature Review of Mental Health Interventions in
Enhancing Student Retention Rates in State Universities
Evidences
Author and year
Mental Health related studies in Philippines’ State Universities.
Banaag et al., 2024
Rungduin et al., 2023
Mansour, 2024
Mental Health and well-being show strong connection to retention of students
in school.
Subosa, 2021
Asanjarani, 2023
Programs and methods related to mental health interventions and in Philippine
context studies.
Jain et al., 2025
LO et al., 2024
Dorji et al., 2023
Azad Noor, 2022
Farre et al., 2024
Reid et al., 2023
Schilpzand et al., 2025
Meyer et al., 2024
Heath et al., 2024
Ibarra-Gambrill, 2021
Bérastégui, 2021
Garlasco et al., 2023
Nash et al., 2024
Vahedi et al., 2023
Rochel, 2024
Baldo et al., 2025
Synthesis
In the Synthesis stage of the SLR, the researcher extracts irrelevant studies and filters duplicated literatures.
This is precisely and thoroughly performed to verify that the information needed and used in discussing the
results and formulating conclusion and recommendation are meaningful and significant to the study.
To this end, the extraction criteria are: year of publication, search engine, types of data source, method, mode
of assessment, and analysis scheme. The aforementioned criteria are filled out to attain the main purpose of the
SLR.
Table 4. The literature inclusion criteria of the Systematic Literature Review of Mental Health Interventions in
Enhancing Student Retention Rates in State Universities (Hamo-ay & Salapa, 2025)
Criteria
Categories Considered
Description
Year of Publication
From 2021to 2025
This SLR includes only the studies within the year
2021- 2025 to ensure updated results.
Search Engine
Google Scholar
To scan and inquire about the related literature of the
mental health intervention in SUCs in the Philippines.
Types of Data Source
Secondary Data
The data are based on the existing literatures.
Method
Qualitative
This is utilized as the mode of elaborating and
summarizing the SLR of mental health intervention in
SUCs in the Philippines.
Mode of Assessment
PSALSAR and PRISMA
2020 Framework
It is being employed to systematically filter the
unnecessary and irrelevant literatures.
Analysis Scheme
Thematic Analysis
This highlights the common patterns of the gathered
literature.
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Data Analysis
To reiterate, this study follows the PSALSAR framework that serves as a guide in completing the SLR as
observed in Table 1. In addition, the presentation of the findings is anchored on the PRISMA 2020 Framework
and employs thematic analysis for the purpose of understanding the relationship between the literatures thereby
resulting in the emergence of common themes to attain the objectives. To this end, the literature has been
divided into two evidences: core and supporting. On one hand, the core evidence exhibits five (5) relevant and
related papers in Google Scholar. On the other hand, 23 papers stand as supporting evidence.
Figure 2. The Thematic Analysis of the Total Included Studies for Systematic Literature Review of Mental
Health Interventions in Enhancing Student Retention Rates in State Universities
RESULTS AND DISCUSSIONS
RQ 1: What are the related studies or literature about the mental health stressors of students?
A total of 14 studies (at 50%) explicitly identified the presence of mental health stressors among university
students with 9 of these being directly situated in Philippine SUCs. The dominant stressor is academic pressure
which has been reported in seven studies. (Banaag et al., 2024) found that heavy workloads, frequent
examinations, and fear of failure are the leading causes of anxiety among students enrolled in SUCs,
contributing to 68% of dropout intentions. (Rungduin, et. al., 2023) highlighted pandemic-induced online
learning fatigue, noting that 40% of students in Philippine higher education institutions (HEIs) experienced
burnout due to prolonged screen time and lack of peer interaction as students during the pandemic only engage
in online classes due to health protocols for that period. (Mansour, 2024) reinforced the same, identifying
grading systems and performance expectations as primary triggers of stress in public universities.
Financial hardship emerged as the second major stressor in five studies. (Balladares et al., 2025) documented
that tuition fees, daily allowances, and family debt significantly elevated depressive symptoms among SUC
students, particularly those from low-income households. (Fadiji et al., 2025), while based in South Africa,
provided a transferable lower-to-middle income countries (LMIC) parallel, to which category the Philippines
also belongs to, showing that public funding gaps exacerbate financial stress and mirror conditions in
Philippine SUCs.
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Digital and social media overload was addressed in three studies. (Jain et al., 2025) reported that problematic
TikTok use led to sleep deprivation, fear of missing out (FOMO), and reduced academic focus among Filipino
college students. Pandemic-related isolation appeared in four studies with (Asanjarani, 2023) noting a global
surge in loneliness that was acutely felt in Philippine SUCs due to campus closures (Rungduin et al., 2023).
Finally, family and cultural expectations were flagged in three studies with (Castro & Kessler, 2021)
explaining how Filipino values of “utang na loob” and parental pressure to succeed intensified stress,
particularly in first-generation college students coming from low-income or poor families.
RQ2: What are the factors of mental health breakdowns of students in the Philippines?
Eleven studies (pegged at 39%) linked stressors to clinical mental health breakdowns, defined as depression,
anxiety disorders, suicidal ideation, or dropout. The most critical factor was untreated chronic stress,
documented in six studies. (Banaag et al., 2024) reported that 68% of students who dropped out had untreated
anxiety symptoms for over six months. Meanwhile, (Rungduin, et. al., 2023) found a 25% prevalence of
moderate-to-severe depression in SUCs with no regular counseling. (Mansour, 2024) also calculated that only
1 counselor existed per 5,000 students, creating a structural barrier to early intervention.
Lack of access to mental health services is the second factor with the said factor being cited in five studies.
(Purgato, et. al., 2023) provided an LMIC model showing that the absence of trained community workers
allows minor stress to escalate into crises. This is a pattern which is directly applicable to understaffed SUC
guidance offices. Stigma and silence were identified in four studies as cultural amplifiers of breakdown.
(Ferguson, et. al.,2023) demonstrated that peer-led stigma prevents help-seeking behaviors among students.
Castro and Kessler (2021) described the Filipino norm of “tiis” (endurance) as a delaying tactic that worsens
outcomes.
Comorbid risks appeared in three studies. (LO et. al., 2024) linked substance abuse with mental health
collapse, noting a vicious cycle of self-medication and academic failure. (Baldo, et. al., 2025) highlighted
teenage pregnancy as a trigger for severe depression and dropout among early college entrants in SUCs.
Collectively, these factors form a pathway: stress and having inadequate or total lack of support coupled with
stigma leads to breakdown among students then, ultimately, results in dropout. As a matter of fact, 71% of
dropouts have experienced, or are showing, this sequence (Banaag, et. al., 2024).
RQ3: What are the gaps in the literature about mental health experiences of students in State Universities and
Colleges (SUCs) in the Philippines?
Despite the existence of literature relating to mental health interventions, gaps continue to exist. Based on the
result, there are numerous gaps that need to be addressed. For instance, 28 references focus only in the Luzon
area with zero primary studies focusing in Davao City SUCs. There is also no intervention trials conducted in
SUCs. Intervention trials are crucial to gauge the effectiveness, relevancy, and appropriateness of the
interventions being implemented in relation to the existing and concrete conditions and uniqueness of student
demographics for a particular learning institution or SUC.
It is essential to note as well that most of the literature are composed only of SLR and descriptive surveys.
Albeit these two being reliable methods employed in countless studies or researches, they still fail to answer
which of the mental health stressors (e.g., counseling, peer support, stress management) have the capacity to
prevent the retention rate from becoming lower. This leaves the Mindanao regions and even the Visayas
regions' unique stressors remain unnoticeable.
Worst, even the faculty’s mental health has taken a toll. It bears stressing that mental health among faculty
members is equally important as they are the ones who are at the forefront of providing support and counseling
to the students. Lastly, to reiterate and further emphasize, (Jain, et. al., 2025) reveals that digital mental health
solutions are absent and pinpoints that there is no SUC in the Philippines that has piloted tele-counseling,
considering that cellphones are now a need for Filipino youth and are, in fact, being used by majority of the
Filipino students in their daily lives.
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RECOMMENDATIONS
In accordance with the findings, the researcher suggests the following recommendations to strengthen the role
of mental health interventions in enhancing student retention rates in SUCs:
1. Pilot testing of tele-counseling in SUCs in Davao Region. Pilot testing of tele-counseling, as an
alternative to physical counseling, is clearly not impossible as the Philippines welcomed the digital age
with technological innovations and developments. In fact, most of the students in SUCs, if not all, have
cellphones. It can also make the lives of both the counselor and the students easier because they have
the option to meet online, which is more cost-effective and efficient at times rather than meeting face-
to-face. Subsequently, the students are less likely to get shy because they can maintain their anonymity
better during online consultations. There are also lower chances that their classmates or peers would
know that they visited the guidance counselor which would lead the students to worry less about what
others would say or think about them.
2. Adopt the Low- and Middle-Income Countries (LMIC) Program Blueprint of (Pugato, et. al,
2023) in Davao City SUCs. This is a program blueprint that trains non-psychologists to deliver basic
counseling and stress management in different sessions. This is akin to the already existing peer
counseling framework, although the said blueprint focuses more on training non-psychologist staff and
faculty members.
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